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Low GFR scores. High Creatinine Scores
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alycia2
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Location: Edmond, Oklahoma USA
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 Posted: Thu Jun 4th, 2009 21:10

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hi everyone,

i went in for blood work and have gotten the results..my gfr scores are low: 42, and my creatinine are high: 1.32. also calcium levels were a bit high: 10.3. all else is normal except for total cholesterol...235 and ldl 136. was tested in feb. of 09,  the gfr was 53 and the creatinine was 1.08...so it would seem that things are getting worse.

my doctor has called and has made some med suggestions which i am going to follow..i have read info on both sites and from what i've read...am to believe that this will resolve..i am just feeling really frightened about it today...does this mean i have kidney damage?

the way i understand gfr..it's kind of like the filters are clogged? is that right?

does exercise effect this...drinking alcohol? salty foods? my doctor has told me to stay well hydrated and he is following me closely..i, in no way feel abandoned...just afraid.

am wondering what others have experienced in this area and what if anything there is i can do to help my kidneys along.

thanks for being here.
alycia



____________________
tested postive for lyme, 1,25D-44 25D-61. terrible neck pain, fatigue, light and sound sensitive, facial numbness,dizziness,insomnia,brain fog.started phase1 nov.08.phase2-feb27,09. current meds are benicar,zith,mino,tramadol,dramamin.
kenc
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 Posted: Thu Jun 4th, 2009 22:16

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alycia2,

Last year I had renal failure while on the MP. My creatinine was 600 (Canada) which I believe is 600/88.1 = 6.79 (USA). It's not unusual for my creatinine to be 130 (Canada) which is 130/88.1 = 1.48 (USA). In February of this year my creatinine was measured well within the normal range. I don't think it's unusual for those on the MP to have abnormally high creatinine. I suggest you read about kidney function here on the MP study site.

Ken

Carricol
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 Posted: Thu Jun 4th, 2009 23:45

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I copied this from the MP site for you.  Read the link to the info below and the link to interview with Dr.  Blaney.  Hopefully this will ease your mind.  Have Doc run 24 hour creatnine clearance test.  If that is normal kidneys will be ok and you can ignore the other results.  Hope this helps. 

Simple explanation of alteration in kidney function tests while on the MP

A lot of MP patients get worried by low eGFR and highish creatinines, and experienced MP doctors know its not important.  Here's a short explanation which I hope helps to explain whats going on.

How to understand the relationship between serum creatinine, eGFR, and creatinine clearance:

Think of the serum creatinine level as a water level in a river. Its a spot measurement.

Think of the 24 hr creatinine clearance as the actual amount of water flowing down the river over 24 hours. This has been measured in your case.

Think of eGFR as a calculation or projection of the water flow, based on the spot measurement of the water level. This is highly inaccurate in certain circumstances, due to several important factors left out. The main assumption is that it never 'rains'.

But on the MP, the harder you herx, the more it 'rains'. So the water level (the serum creatinine) rises. But in most people on the MP, the river flow is not compromised at all (ie kidney function as measured accurately by 24 hr creatinine clearance) . We already know this intuitively because we know that its 'raining', ie that you are having high cell turnover and making a lot of creatinine due to herx. And we can know this deductively because you did a 24hr urine, and measured the amount of creatinine cleared in 24 hrs, which was completely normal.

So, when on the MP, serum creatinine and especially eGFR are really NOT showing what is going on. Much more important is 24 hr creatinine clearance. When 24 hr creatinine clearance is normal, then you know that you can ignore eGFR and serum creatinine, because they are only telling you how hard it is 'raining', and not how well your kidneys are functioning at all.

And those who do have real kidney impairment need to be checking 24 hr creatinine clearances and spot potassium levels. Potassium levels are very important to cardiac function, and high levels or low levels can trigger cardiac arrythmias.

Personally in most MP patients, I would more likely order a 24 hr creatinine clearance for a rising potassium level than a rising creatinine level on its own. Rising creatinine on its own needs to be managed as a sign of herxing, and managed by modulating the herxing in the usual way (increase olmesartan, adjust antibiotics etc).

I hope this helps you understand the numbers and what they do and do not represent.  ~Dr. Nyrie Dodd



http://curemyth1.org/reply.php?topic_id=2473

http://bacteriality.com/2007/10/31/blaney/



____________________
Sarcoidosis, Arthritis, Fallen Arch, Vascular Insufficiency, Cataracts,fatty liver,low thyroid,diverticulosis, Fuchs Dystrophy, depression| 1,25D 16 (Oct08) | Ph1 Nov07, Ph2 Jan08, Ph3 May 09 Ben Only: Jun 10- Sep 10|Break Sep 10-Dec 10|Resume MP Dec 10|
alycia2
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 Posted: Fri Jun 5th, 2009 02:35

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hi ken,
what did you do when your kidneys failed? and now you are doing ok? did you just keep improving? i did read the info that meg wrote...and i realize that my numbers are not close to failure...just not where they should be and worrisome...

please let me know what you went through and how it has resolved...

thank you,
alycia



____________________
tested postive for lyme, 1,25D-44 25D-61. terrible neck pain, fatigue, light and sound sensitive, facial numbness,dizziness,insomnia,brain fog.started phase1 nov.08.phase2-feb27,09. current meds are benicar,zith,mino,tramadol,dramamin.
kenc
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 Posted: Fri Jun 5th, 2009 06:01

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alycia2,

I went to the hospital when my kidneys failed. The clue for me is that I stopped urinating for a couple of days. was also very very week. While in the hospital I was hydrated inter venously and given a blood transfusion with 3 units of blood.

I believe the kidney failure was a result of both dehydration (from diarrhea)and immunopathology. At first I thought it was just dehydration because I have Crohn's disease, however, my doctor convinced me it was from immunopathology as well. Many patients on the protocol who don't have diarrhea have kidney problems.

After the hospital I drank more fluids and reduced my antibiotics. The first to prevent dehydration, the second to decrease the immunopathology that was affecting my kidneys.

Ken

alycia2
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 Posted: Fri Jun 5th, 2009 13:52

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thanks carricol for the link to dr. blaney's site. it helped to read it and in some ways made me feel like my body is doing exactly what it is suppose to be doing.

i just need to chill out...do the med changes rec. by my doctor and realize that this kind of stuff is going to come up..i feel so much better most of the time then i did pre mp...i have fatique and dizziness..i have emotional herxing...some depression..and i have issues with anxiety but none of that is like the unrelenting pain i was in and the total brain fog...like everything around me wasn't quite real and i couldn't partake in any of it. it was so awful...

thank you again for your interest and support. i intend to stay well hydrated!

i hope your recovery is coming along nicely...:)
alycia



____________________
tested postive for lyme, 1,25D-44 25D-61. terrible neck pain, fatigue, light and sound sensitive, facial numbness,dizziness,insomnia,brain fog.started phase1 nov.08.phase2-feb27,09. current meds are benicar,zith,mino,tramadol,dramamin.
Deedee
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 Posted: Sat Jun 6th, 2009 03:31

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Several months ago I had a very high BUN, a slightly elevated Creatinine and a low eGFR.  I was really afraid.

What I learned was this: 

The eGFR is a calculated value based on your creatinine.  It is an estimate.  that is what the "e" stands for. It does not mean you are in kidney failure.  My doctor said he hates the eGFR because it unnecessarily freaks people out.

When the BUN goes up that means your kidneys are working hard to remove debri of dead bacteria.   My lymph nodes were also swollen.  I was having a big bacteria die-off.  This can also impact your creatinine.

I was advised by my doctor and TM to cut back on the antibiotics for a little bit, to control the IP better.   I dropped from mid Phase II to mid Phase I for 2 months/ and repeated the blood work. the kidney values were normal.  When I dropped back to mid-Phase I, I also had less fatigue and my lymph nodes quickly reduced in size.

I am now in the processing of ramping up again, but I will go slower and pay more attention to fatigue and anxiety as IP.

Look at this link:  http://www.marshallprotocol.com/view_topic.php?id=2487&forum_id=32

Try reducing sunlight and Vitamin D in your diet and see if your calcium decreases.



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Sarcoidosis lymphopathy (July 08) | 125D53 25D54 Jul08 | Ph1Aug08 Ph2Nov08 Ph1Mar09 ModPh2Aug09 Ph1Sep09 ModPh2Oct09 Ph1Dec0| ModPh2July10| 25D24 (Nov08) 25D25 (Feb09) 25D15 (May09) 25D14 (Dec09) 25D11 (Mar10)
alycia2
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 Posted: Sat Jun 6th, 2009 17:28

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hi deedee,

thank you for your post. i am feeling calmer now. i came across a site that calculates your egfr and at that point i started to realize that this was an estimation..it has you put in your age, ethnicity and creatinine scores and then gives you what your gfr is est. to be...so, i thought then that maybe the numbers weren't exactly what is going on. my bun was within normal ranges...higher ranges but still within limits...high on the creatinine score but not that bad...

i have been taking benicar four times a day and my doctor has suggested that i bring that down a bit...that my innate immune system may have been activated to the point that things are going to fast...we will do a follow up on monday...so far, i am feeling better.

i think i must be like you in that fatique and anxiety can creep up on me...it can get pretty bad before i realize that it's that bad..if that makes sense? the last couple of weeks i have been so tired...i found myself needing 12 hours a sleep a night and then wanting to take naps in the afternoon...i thought of it as ip's but just didn't know what to do...that's where having a good doctor is so valuable.

i would have anxiety at weird moments and benicar didn't seem to help that...which would make me feel more anxious...i would take valium and that would help..but mostly if i could just get home or everyone at the house would leave...or i could sleep...then i would feel better...sort of...anyway..

thank you for your post..i feel more assured..i believe again that i am on the right track..i am taking 20 mg. of benicar every four hours...seems to be right for me today...

the mp and really being ill with th1 puts a whole new meaning to "every day is a new day";)

glad you got a handle on your situation and are doing better...we are just about at the same place..i am in phase2 on 62.5 zith and 75. mg. on mino..benicar 40mg 3-4 times a day...

take care...
alycia



____________________
tested postive for lyme, 1,25D-44 25D-61. terrible neck pain, fatigue, light and sound sensitive, facial numbness,dizziness,insomnia,brain fog.started phase1 nov.08.phase2-feb27,09. current meds are benicar,zith,mino,tramadol,dramamin.
Deedee
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 Posted: Sat Jun 6th, 2009 17:56

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"i am in phase2 on 62.5 zith and 75. mg. on mino..benicar 40mg 3-4 times a day..."

That is where I was when it hit me.  I dropped back to mid-Phase I at 50 mino for  months.  I am now ramping back up but more slowly.

Perhaps you might consider talking to your doctor about backing down on the antibiotics until your lab work is better?  Zith is a powerful antibiotic and it seems that more than a few people hit a wall in Phase II with the Zith.

Like you, I thought I was doing very well with the IP because I was not considering the fatigue and anxiety as IP.  After dropping back, my fatigue and anxiety improved a whole lot, my lymph nodes in my neck decreased in size to almost normal, and my BUN and creatinine are normal.  Even my calcium is lower.  Currently, I have a little low WBC count and a little high ALT, but I am not worried because the BUN experience helped me realize that there is a lot of bacterial killing going on and it will show up in lab work. 

I just ramped up to 75 of mino and I am taking it very slowly.  I will not ramp to 100 mino until I am sure the fatigue is not bad and my anxiety is not bad.  I have noticed an increase a little in the fatigue, so I will tread water until that is better.  You may be like I am and need to consider the fatigue and anxiety as serious IP.

I am glad you are feeling less worried.  It is such a bummer to get freaked out over the lab tests.  Getting through the other side of a bad lab experience is really helpful and will make you stronger the next time a lab value is out of range.

Get lots of rest and think about reducing IP (with consultation of your doctor) by reducing the antibiotics for a while. The Benciar really is protective, and renal protective at that.  There are studies on line that show Benicar helps people in renal failure (not that you are in renal failure.)   I stayed on my Q6 Benicar while I was waiting for my IP to calm down after reducing my antibiotics. I wouldn't blame the Benicar. 



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Sarcoidosis lymphopathy (July 08) | 125D53 25D54 Jul08 | Ph1Aug08 Ph2Nov08 Ph1Mar09 ModPh2Aug09 Ph1Sep09 ModPh2Oct09 Ph1Dec0| ModPh2July10| 25D24 (Nov08) 25D25 (Feb09) 25D15 (May09) 25D14 (Dec09) 25D11 (Mar10)
Carricol
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 Posted: Sat Jun 6th, 2009 18:47

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Alycia,

Did you consider asking Doc to run 24 hour creatnine clearance test.  It is the acid test to confirm kidneys are working properly when on MP.  My BUN and GFR have been consistently out of whack for over a year.  Doc got freaked out at one point.  I have done creatnine clearance three times.  It has always been normal.  So, I do not worry.  Doc as calmed down and accepted the fact that when on MP the Bun, Creatnine, and GFR measure how hard you are herxing not how well your kidneys are working.  The best test to accurately measure your kidney function on the MP is the 24 hour test.  If that comes back normal do not freak out on the others.  Treat them as markers for how hard you are herxing and not how well your kidneys are working. 



____________________
Sarcoidosis, Arthritis, Fallen Arch, Vascular Insufficiency, Cataracts,fatty liver,low thyroid,diverticulosis, Fuchs Dystrophy, depression| 1,25D 16 (Oct08) | Ph1 Nov07, Ph2 Jan08, Ph3 May 09 Ben Only: Jun 10- Sep 10|Break Sep 10-Dec 10|Resume MP Dec 10|
alycia2
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 Posted: Sun Jun 7th, 2009 14:49

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yes, deedee, i think i do need to consider the fatigue and anxiety as serious herxing. this last time i ramped my mino to 75, i had the feeling that i should wait. i was so tired and having some dizziness even...i forget sometimes the part where we move once our symtoms are manageable..i remember doing it...while knowing i shouldn't but having the feeling of wanting to just push on and get through with this...

it's summer for god's sake..!!! and of course, my favorite thing use to be to lay out and work in the yard and get brown as a berry...asap...

last night after sunset, we swam and it felt so good to be in the water...and it dawned on me..last summer i was so sick i didn't get in the pool once...i could barely sit out there and watch my family...it's so important to keep things in perspective.

i will talk to my doctor tomorrow..and let him know how it's been going this weekend..also ask him about the 24 hour clearance test and staying where i am or backing off the anbx...pretty cool to have so many choices to manage this and also so great to have others who have come before, willing to share...it makes this so much less scary.

when i ask my body inside and really think about it...i feel like i am going to be ok..this is just a part of my healing and my body is working hard doing everything that it can to make it's self well..my job it to help it by eating well, resting, being kind, and paying attention.

thanks deedee.
alycia



____________________
tested postive for lyme, 1,25D-44 25D-61. terrible neck pain, fatigue, light and sound sensitive, facial numbness,dizziness,insomnia,brain fog.started phase1 nov.08.phase2-feb27,09. current meds are benicar,zith,mino,tramadol,dramamin.
alycia2
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 Posted: Sun Jun 7th, 2009 15:03

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thanks carricol. i will ask my doc on monday about the 24 hr. clearance test. i am feeling better..have calmed down...know i'm herxing. considering staying where i'm at with anbx or going back a bit...just going to talk things over with him...i'm feeling ok though, so maybe if i have the test and it comes back ok..i will just keep going.

we'll see..the best deal is, at this point, my anxiety about having kidney damage has lessoned..not entirely gone, but i don't feel so panicky..doing the mp is complicated...i have been reading a lot this weekend..it's like i have found a whole new layer of information...i've started reading the info about the implications of cancer and the mp...just amazing how long this research has been going and how intense it is to try to understand this process...and how much information there is to consider.

wouldn't it be truly wonderful if this research turns out to be the missing link to so many horrible maladies...with all the new vitamin d requirements, in a few years, there are going to be so many more sick people...that alone may be what will drive the mp into the mainstream...:shock:

take care carricol and thank you for your interest and care.
alycia




____________________
tested postive for lyme, 1,25D-44 25D-61. terrible neck pain, fatigue, light and sound sensitive, facial numbness,dizziness,insomnia,brain fog.started phase1 nov.08.phase2-feb27,09. current meds are benicar,zith,mino,tramadol,dramamin.
Carricol
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 Posted: Sun Jun 7th, 2009 21:43

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If 24 hour creatnine clearance test comes back normal I personnally would consider the out of range GFR, Creatnine, and Bun as a good sign and not bad sign as long as they do not go too far out of range.  It is proof positive that the MP is woking and doing what it is supposed to do...Kill pathogens.  These out of range readings are proof positive that pathogens and infected cells are dying and releasing their toxic debris into your system.  They may also indicate that your kidneys may be affected by the Th1 pathogens.  These readings can help you manage the pace of the therapy. 



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Sarcoidosis, Arthritis, Fallen Arch, Vascular Insufficiency, Cataracts,fatty liver,low thyroid,diverticulosis, Fuchs Dystrophy, depression| 1,25D 16 (Oct08) | Ph1 Nov07, Ph2 Jan08, Ph3 May 09 Ben Only: Jun 10- Sep 10|Break Sep 10-Dec 10|Resume MP Dec 10|
JoshR
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 Posted: Mon Jun 8th, 2009 12:42

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alycia2 wrote:
i have been taking benicar four times a day and my doctor has suggested that i bring that down a bit...that my innate immune system may have been activated to the point that things are going to fast...

Decreasing Benicar would be the last thing I would do if I were in your position. The guidelines, which are based on the science and the experience of those who have gone before, are very clear that increasing Benicar and decreasing abx are the main ways to reduce IP.

Benicar doesn't just activate the VDR, it has multiple effects which kick in at different dosing levels.

Is the 25-D level in your signature current? If so, you'd expect your IP to be rather unstable. Dr Marshall has actually started recommending that people stay in Phase 1 until their 25-D gets below 25 ng/ml or so.



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alycia2
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 Posted: Mon Jun 8th, 2009 15:21

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hi josh,

my doctors suggestion was only for the weekend. i had actually been taking benicar almost every four hours...so i slowed it down to three times a day...20mg every four hours. i am getting ready to call him now and we will talk about what to do.

i did notice less fatigue..but, i know from all the reading that the anbx doses need to be manipulated more than the benicar...i am waiting for the results from my latest bloodwork...my last numbers came in at 38 so i am headed in the right direction.

i have taken extra time in ramping anbx...waiting until i feel reasonably well before preceding...but this last time i was still feeling bad but out of impatience and some depression over being shut up in the house...i think i just decided to push on...not a good idea.

then started really feeling awful and went in to see my doctor..he ran the blood work and found these things going on...so it may be that i need to back down a bit..i am feeling better though and will not ever do less than 120mg. a day of benicar...i think i feel the best at 160mg..

i will do a follow up post after we talk today.

thanks,
alycia



____________________
tested postive for lyme, 1,25D-44 25D-61. terrible neck pain, fatigue, light and sound sensitive, facial numbness,dizziness,insomnia,brain fog.started phase1 nov.08.phase2-feb27,09. current meds are benicar,zith,mino,tramadol,dramamin.

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